Medock, Yvonne Carlo
Medock, Yvonne Carlo is an individual health care provider with primary practice located at 190 E. Highland Ave , San Bernardino CA 92404-3658. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Medock, Yvonne Carlo can be contacted via phone (909) 882-4788.Contact Information
Primary practice address
190 E. Highland Ave
San Bernardino CA 92404-3658
Phone: (909) 882-4788
Fax: (909) 882-8819
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | AP30006841 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 11606 | California |
Profile Details
| NPI number | 1700948924 |
|---|---|
| LBN Legal business name | Medock, Yvonne Carlo |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 14th, 2006 |
| Last updated | May 22nd, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700948924 | NPPES |
| California | Other | P01805640-DU5182 | RAILROAD MEDICARE |
| California | Other | 07252016 | RAILROAD MEDICARE |
| California | Other | P01288547/DU4034 | RAILROAD MEDICARE |
| California | MEDICAID | EFF:2/21/13-FONTANA | RAILROAD MEDICARE |
| California | MEDICAID | EFF.4/23/13-S.RIVERS | RAILROAD MEDICARE |
| California | MEDICAID | EFF:2/21/13 SAN BERN | RAILROAD MEDICARE |
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